Prevalence and management of familial hypercholesterolaemia in patients with acute coronary syndromes.

AIMS We aimed to assess the prevalence and management of clinical familial hypercholesterolaemia (FH) among patients with acute coronary syndrome (ACS). METHODS AND RESULTS We studied 4778 patients with ACS from a multi-centre cohort study in Switzerland. Based on personal and familial history of premature cardiovascular disease and LDL-cholesterol levels, two validated algorithms for diagnosis of clinical FH were used: the Dutch Lipid Clinic Network algorithm to assess possible (score 3-5 points) or probable/definite FH (>5 points), and the Simon Broome Register algorithm to assess possible FH. At the time of hospitalization for ACS, 1.6% had probable/definite FH [95% confidence interval (CI) 1.3-2.0%, n = 78] and 17.8% possible FH (95% CI 16.8-18.9%, n = 852), respectively, according to the Dutch Lipid Clinic algorithm. The Simon Broome algorithm identified 5.4% (95% CI 4.8-6.1%, n = 259) patients with possible FH. Among 1451 young patients with premature ACS, the Dutch Lipid Clinic algorithm identified 70 (4.8%, 95% CI 3.8-6.1%) patients with probable/definite FH, and 684 (47.1%, 95% CI 44.6-49.7%) patients had possible FH. Excluding patients with secondary causes of dyslipidaemia such as alcohol consumption, acute renal failure, or hyperglycaemia did not change prevalence. One year after ACS, among 69 survivors with probable/definite FH and available follow-up information, 64.7% were using high-dose statins, 69.0% had decreased LDL-cholesterol from at least 50, and 4.6% had LDL-cholesterol ≤1.8 mmol/L. CONCLUSION A phenotypic diagnosis of possible FH is common in patients hospitalized with ACS, particularly among those with premature ACS. Optimizing long-term lipid treatment of patients with FH after ACS is required.

The use of electromyography interference pattern analysis to determine muscle force of the deep digital flexor muscle in healthy and laminitic horses

BACKGROUND: In equine laminitis, the deep digital flexor muscle (DDFM) appears to have increased muscle force, but evidence-based confirmation is lacking. OBJECTIVES: The purpose of this study was to test if the DDFM of laminitic equines has an increased muscle force detectable by needle electromyography interference pattern analysis (IPA). ANIMALS AND METHODS: The control group included six Royal Dutch Sport horses, three Shetland ponies and one Welsh pony [10 healthy, sound adults weighing 411 ± 217 kg (mean ± SD) and aged 10 ± 5 years]. The laminitic group included three Royal Dutch Sport horses, one Friesian, one Haflinger, one Icelandic horse, one Welsh pony, one miniature Appaloosa and six Shetland ponies (14 adults, weight 310 ± 178 kg, aged 13 ± 6 years) with acute/chronic laminitis. The electromyography IPA measurements included firing rate, turns/second (T), amplitude/turn (M) and M/T ratio. Statistical analysis used a general linear model with outcomes transformed to geometric means. RESULTS: The firing rate of the total laminitic group was higher than the total control group. This difference was smaller for the ponies compared to the horses; in the horses, the geometric mean difference of the laminitic group was 1.73 [geometric 95% confidence interval (CI) 1.29-2.32], and in the ponies this value was 1.09 (geometric 95% CI 0.82-1.45). CONCLUSION AND CLINICAL RELEVANCE: In human medicine, an increased firing rate is characteristic of increased muscle force. Thus, the increased firing rate of the DDFM in the context of laminitis suggests an elevated muscle force. However, this seems to be only a partial effect as in this study, the unchanged turns/second and amplitude/turn failed to prove the recruitment of larger motor units with larger amplitude motor unit potentials in laminitic equids.

Transregional Interactions between Jansenists, other Catholics, and Protestants in Seventeenth Century Northern Europe

This paper discusses the theological and cultural exchanges between Catholic clergy and theologians, and specifically between the neo-Augustinian-minded, the so-called “Jansenists”, and other Catholics, in Northern Europe during the seventeenth century. It also explores the Jansenists’ encounters and theological engagement with Protestantism. In this period, interaction and transfer between French Jansenist Catholics and other Catholics in other countries took place in various ways: 1. Via traveling and migration: French theologians and clergy returned home from their travels with reports about the situation of Catholicism and Protestantism in other countries; moreover, in the second half of the 17th century, French Jansenists fled to the northern Netherlands. 2. Via networking: it is little known that for a brief period on the North Sea island of Nordstrand, adherents to Port-Royal were buying land, and clergy of the Flemish Oratory provided pastoral care for the island’s Catholics. This project was not successful, but at the end it strengthened the network between French “Jansenists” and Catholics in the Dutch Republic. 3. Via publications by leading Jansenists and their counterparts. In this paper, the focus is on the view of Protestantism held by Jansenist writers.

Aspectos de la tradición clásica en América : Sibilas y Triunfos en La Casa del Deán de Puebla de los Ángeles (México)

Dentro de la pintura mural civil mexicana del siglo XVI, ubicamos dos anónimas series iconológicas en dos habitaciones de la Casa del Deán de la ciudad de Puebla: Sibilas y Triunfos realizadas en 1580. Analizamos la posible procedencia del modelo sibilino, su número, particularidades, la composición de la serie y los problemas que presenta. Seguimos el mismo procedimiento para los Triunfos, cuya fuente literaria son los Trionfi de F. Petrarca; otro elemento a considerar son las guardas o cenefas que enmarcan cada serie con flora y fauna tropical americana. Concluimos con el tipo de síntesis plástica lograda

Aspectos de la tradición clásica en América : Sibilas y Triunfos en La Casa del Deán de Puebla de los Ángeles (México)

Dentro de la pintura mural civil mexicana del siglo XVI, ubicamos dos anónimas series iconológicas en dos habitaciones de la Casa del Deán de la ciudad de Puebla: Sibilas y Triunfos realizadas en 1580. Analizamos la posible procedencia del modelo sibilino, su número, particularidades, la composición de la serie y los problemas que presenta. Seguimos el mismo procedimiento para los Triunfos, cuya fuente literaria son los Trionfi de F. Petrarca; otro elemento a considerar son las guardas o cenefas que enmarcan cada serie con flora y fauna tropical americana. Concluimos con el tipo de síntesis plástica lograda

Aspectos de la tradición clásica en América : Sibilas y Triunfos en La Casa del Deán de Puebla de los Ángeles (México)

Dentro de la pintura mural civil mexicana del siglo XVI, ubicamos dos anónimas series iconológicas en dos habitaciones de la Casa del Deán de la ciudad de Puebla: Sibilas y Triunfos realizadas en 1580. Analizamos la posible procedencia del modelo sibilino, su número, particularidades, la composición de la serie y los problemas que presenta. Seguimos el mismo procedimiento para los Triunfos, cuya fuente literaria son los Trionfi de F. Petrarca; otro elemento a considerar son las guardas o cenefas que enmarcan cada serie con flora y fauna tropical americana. Concluimos con el tipo de síntesis plástica lograda